New Fertility Treatment: Gonal-F & Ovidrel

So as you may have realized from the fact that I'm writing about a new treatment, the clomid/IUI combo did not work.  Which isn't surprising, since it just increases the chances of my conceiving on a particular month from 0.1% to 8-10%.  Which is a huge improvement, but still an expected 90-92% failure rate.  It's cheap though (comparatively), so it was worth a try.

Now we're stepping up into the bigger leagues.  Injectible medications (Gonal-f), an HCG trigger (Ovidrel) and then two back-to-back IUIs.  Below are all the steps involved in this round.  I'll update in the comments.

Injection lesson. I went in for an injection lesson where the nurse answered a million questions, showed me how to use the gonal-f pen and let me inject a stress ball with saline. Wheee.  They gave me lots of paperwork (I adore having something to read at home to refresh my memory) and we called the pharmacy to have the drugs delivered.

Drug delivery. The drugs come FedEx with an ice pack and they have to go straight to the fridge.  I opened a packet to see what they looked like and everything looks just like it did at the injection lesson.  The order came with a sharps container, the needles, the drugs and some alcohol & gauze pads.

Cycle Day (CD) 2  Ultrasound.  Went in for an ultrasound to make sure there are no cysts and that it's safe to start the drugs.  It is! (For anyone who cares, that ultrasound could have been CD2 or CD3. CD2 just worked with my work schedule better.)

CD3 - medicate. I started giving myself the injections on CD3.  For me, the first dose is 112.5, then 75 for the next two days.  The meds come in a pen (sort of like an epi pen) that has a dial on it to allow me to set the dose for the day.  The first time I used it, I set the dial to 37.5, pulled out the plunger and then injected the meds into the sharps container I got (to prime the pen).  Then came the moment of truth. 
I set it for 112.5, pulled out the plunger.  I wiped off a spot on my abdomen, pinched the skin and then pushed the needle into my skin (EWWWWW) and depressed the plunger.  Draw the needle out, use pressure with a gauze pad to prevent/decrease bruising.  Give it a minute to congratulate myself for being a big girl and to hold the pressure, then take the sharp off the pen, put it in the container and put away all the meds.  Look at my belly and tell it to hurry up and make me some eggs.

CD4 & 5 - medicate.  I'll keep doing this for the next two days, at the same time everyday.  The dose should be given between 6pm and 9pm, so for my schedule 9pm is the only one I can do consistently.

CD 6 - b/w & u/s.  On CD6, I go in for blood work to check my estradiol levels, then I have an ultrasound in the afternoon to monitor the follicle growth.  The nurse will give me a call with my expected next three doses and I give myself the gonal-f shots in the evening.

Repeat the above until the follicles are big enough.  For my doc, that will be when we have enough that are over 20mm (hence all of the $300-a-pop ultrasounds).  At that point, he'll let me know that it's time to trigger.

Trigger.  I use the Ovidrel to trigger - it's a shot of HCG that should make me ovulate.  It's sitting in the fridge, waiting on the doc's order to use it.

IUI #1.  Approximately 12 hours later (I think), I go in for the first of two IUIs.

IUI #2. 24-36 hours later I get the second IUI. (And, in fertility forums parlance, we go home and do the babydance.)

Two week wait.  I bite my nails and freak out for two weeks, while we hope that this took and I'm preggers.  I could POAS (pee on a stick), but the definitive answer will come from another blood test (called a beta).

Hopefully, this will work (what with the stress and the money involved).  This procedure has a chance of conception at something like 20-23%.  Which is way better than before, but keep in mind that's still at 77-80% failure rate.  That's not the best odds in the world.

So if it doesn't work, we have to decide if we want to do another round of injectible/IUI or if it's time to move onto the big daddy - IVF.  As New Boss likes to say (grrrr), we'll cross that bridge when the issue comes up.